Heart failure, part two

Now it's time for the bummer news about heart failure (HF).Historically, there's been no treatment that improves outcomes for those HF patients who have an ejection fraction of greater than or equal to 45%. And, we learned today, there still isn't.

Researchers studied whether treating these patients with irbesartan (an ARB) might lower death and hospitalizations for HF, MI, stroke and arrhythmia. It was the largest study of an ARB for this condition, ever, with 4,128 subjects and a 4.5 year follow-up. The average patient age was 72 years and 60% were women-- appropriate given that that this condition mostly affects women and older folks.

There was a difference in those who took irbesartan vs. placebo, but it wasn't significant. At least, the researchers said, the study showed the drug was safe, which means it could be a good substitute for patients who can't tolerate other hypertension drugs. But, as Philip Poole-Wilson, MD, said in his inimitable English accent about the exercise and heart failure study: "Safety without benefit is a bit dull, really."

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